Introduction
Big toe metatarsophalangeal joint arthrosis is also known as “hallux rigidus” and is a disease of the forefoot. This clinical picture is characterized by arthrosis in the metatarsophalangeal joint of the big toe, i.e. so-called joint degeneration. After hallux valgus, metatarsophalangeal joint arthrosis is the second most common disease of the foot. It manifests itself mainly after the age of 40 and is more typical for the female sex.
Causes
How big toe metatarsophalangeal joint arthrosis occurs has not yet been conclusively clarified. However, certain factors are discussed as triggers for hallux rigidus. These include wearing the wrong shoes, the presence of a shortened Achilles tendon, inflammatory diseases, an enormously extended first ray of the toe or its elevation and incorrect weight bearing.
The last mentioned cause can be caused by a flattened arch of the foot. However, metatarsophalangeal joint arthrosis of the big toe can also result from a hereditary predisposition. Even the smallest injuries in the area of the metatarsophalangeal joint of the big toe can also provoke arthrosis at this point. In addition, other foot deformities such as hallux valgus or metabolic disorders, such as gout, increase the likelihood of arthritis of the metatarsophalangeal joint of the big toe.
Symptoms
The two main symptoms of metatarsophalangeal joint arthrosis are pain and joint stiffness. On the one hand, the pain is caused by bony changes in the area of the metatarsophalangeal joint of the big toe, so-called small bumps or bony protrusions on the dorsal side of the foot, i.e. on the back of the foot. These bony protrusions are also called “osteophytes”.
They look like small lumps over the joint and can cause pain by irritating the surrounding tissue. The irritation is caused by the fact that shoes that previously fitted the foot suddenly become too tight and the bone protrusions become pressure or friction points. The pain is accompanied by symptoms such as swelling, redness at the corresponding irritated area and overheating.
The pain naturally increases with movement, as this aggravates the irritation. Therefore, it is not uncommon for affected patients to experience a change in gait pattern. Patients try to prevent the painful rolling movement in the metatarsophalangeal joint of the big toe by adopting a relieving posture and a limping gait.
They therefore also roll over the outer edge of the foot to compensate for this. This tendency is accompanied by an internal rotation of the foot. Depending on the severity of the metatarsophalangeal joint arthrosis of the big toe, however, even just standing can cause pain.
The second main symptom of joint degeneration is joint stiffness. Due to the arthrosis, i.e. the joint wear and tear, the metatarsophalangeal joint of the big toe is less and less mobile, so that the restriction of movement has finally progressed so far that one can speak of a stiffened joint. As the final link in the causal chain of pain, incorrect loading, altered gait pattern and relieving posture, problems can result in the knee and hip area.
